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Alves LVGL, Pires CRF, Sousa-Neto MD, Prado HS, Mazzi-Chaves JF, Candemil AP. Metal artifact reduction tool and mA levels impact on the diagnosis of fracture extension in endodontically treated teeth using cone-beam CT. Clin Oral Investig 2024; 28:531. [PMID: 39298025 DOI: 10.1007/s00784-024-05945-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 09/14/2024] [Indexed: 09/21/2024]
Abstract
AIM To evaluate the influence of different levels of metal artifact reduction (MAR) tool and milliamperage (mA) on the diagnosis of fracture extension in endodontically treated teeth using cone beam CT (CBCT). MATERIALS AND METHODS Ten maxillary premolars were endodontically treated and positioned in the empty sockets of a human maxilla covered with wax. CBCT acquisitions were performed using the Eagle Edge device (Dabi Atlante, Brazil) adjusted to 120 kVp, FOV of 4 × 6 cm, exposure time of 24 s and voxel size of 0.2 mm in 8 different conditions with different MAR (1, 2 and 3) and mA (3.2 and 6.3) levels. Crown-root fractures were simulated in the universal testing machine, and CBCT images were acquired again. Five radiologists evaluated the presence and extension of fractures with a 5-point scale. Statistical analysis was performed by analysis of variance, Tukey and Kappa test (α = 0.05). RESULTS Although different mA levels did not significantly (p > 0.05) affect the diagnosis values for fracture presence and extension, when evaluated the different levels of MAR, AUC and sensitivity showed significantly higher values (p < 0.05) for MAR 0 using 6.3 mA and kappa agreement showed significantly higher values (p < 0.05) for MAR 0 and 2 using 6.3 mA. CONCLUSIONS Although mA levels do not have a diagnostic effect when isolating the MAR level; in 6.3 mA, MAR 0 and 2 can positively influence the diagnosis of fracture extension in endodontically treated teeth using CBCT. CLINICAL RELEVANCE The isolate evaluation of dental fracture presence can overlook diagnostics error of its extension.
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Affiliation(s)
- Luísa Valente Gotardo Lara Alves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Cassiano Ricardo Ferreira Pires
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Heitor Silva Prado
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil.
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café- Subsetor Oeste - 11 (N-11), Ribeirão Preto, São Paulo, 14040-904, Brazil
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Cao W, Parvinian A, Adamo D, Welch B, Callstrom M, Ren L, Missert A, Favazza CP. Deep convolutional-neural-network-based metal artifact reduction for CT-guided interventional oncology procedures (MARIO). Med Phys 2024; 51:4231-4242. [PMID: 38353644 DOI: 10.1002/mp.16980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/20/2023] [Accepted: 01/22/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Computed tomography (CT) is routinely used to guide cryoablation procedures. Notably, CT-guidance provides 3D localization of cryoprobes and can be used to delineate frozen tissue during ablation. However, metal-induced artifacts from ablation probes can make accurate probe placement challenging and degrade the ice ball conspicuity, which in combination could lead to undertreatment of potentially curable lesions. PURPOSE In this work, we propose an image-based neural network (CNN) model for metal artifact reduction for CT-guided interventional procedures. METHODS An image domain metal artifact simulation framework was developed and validated for deep-learning-based metal artifact reduction for interventional oncology (MARIO). CT scans were acquired for 19 different cryoablation probe configurations. The probe configurations varied in the number of probes and the relative orientations. A combination of intensity thresholding and masking based on maximum intensity projections (MIPs) was used to segment both the probes only and probes + artifact in each phantom image. Each of the probe and probe + artifact images were then inserted into 19 unique patient exams, in the image domain, to simulate metal artifact appearance for CT-guided interventional oncology procedures. The resulting 361 pairs of simulated image volumes were partitioned into disjoint training and test datasets of 304 and 57 volumes, respectively. From the training partition, 116 600 image patches with a shape of 128 × 128 × 5 pixels were randomly extracted to be used for training data. The input images consisted of a superposition of the patient and probe + artifact images. The target images consisted of a superposition of the patient and probe only images. This dataset was used to optimize a U-Net type model. The trained model was then applied to 50 independent, previously unseen CT images obtained during renal cryoablations. Three board-certified radiologists with experience in CT-guided ablations performed a blinded review of the MARIO images. A total of 100 images (50 original, 50 MARIO processed) were assessed across different aspects of image quality on a 4-point likert-type item. Statistical analyses were performed using Wilcoxon signed-rank test for paired samples. RESULTS Reader scores were significantly higher for MARIO processed images compared to the original images across all metrics (all p < 0.001). The average scores of the overall image quality, iceball conspicuity, overall metal artifact, needle tip visualization, target region confidence, and worst metal artifact, needle tip visualization, iceball conspicuity, and target region confidence improved by 34.91%, 36.29%, 39.94%, 34.17%, 35.13%, and 45.70%, respectively. CONCLUSIONS The proposed method of image-based metal artifact simulation can be used to train a MARIO algorithm to effectively reduce probe-related metal artifacts in CT-guided cryoablation procedures.
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Affiliation(s)
- Wenchao Cao
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ahmad Parvinian
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel Adamo
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Brian Welch
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Liqiang Ren
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Andrew Missert
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Zhu T, Zhou G, Chen C, Wang J, Gu P, Zhang J, Wu H, Zhao X, Leng D, Wu D. Quantitative evaluation of artifact expression in conebeam computed tomography of mesoporous calcium silicate nanoparticles as a promising root canal sealer. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:500-507. [PMID: 37453920 DOI: 10.1016/j.oooo.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/08/2023] [Accepted: 05/13/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES We aimed to quantitatively compare the area and volume of artifacts in cone beam computed tomography produced by mesoporous calcium silicate nanoparticles (MCSNs), AH Plus sealer, and iRoot SP sealer when used as root canal sealers. METHODS We prepared 40 single-rooted mandibular premolars and divided them into an MCSN sealer group, an AH Plus sealer group, an iRoot SP sealer group, and a no-sealer (control) group. We filled the canals with gutta-percha using the single-cone method and subjected them to conebeam computed tomography before and after the placement of root fillings using the same exposure parameters. We evaluated the images to quantify the areas of hyperdense and hypodense artifacts and non-affected teeth and reconstructed 3-dimensional image models of the materials to study volume distortion artifacts. RESULTS The MCSN sealer group produced a significantly smaller hyperdense and volume distortion artifacts than the AH Plus and iRoot SP groups (P < .01), but the area and volume of hypodense artifacts did not differ significantly among the groups (P > .05). CONCLUSIONS When used as a root canal sealer, MCSNs generate a significantly smaller area and volume of hyperdense artifacts than AH Plus and iRoot SP sealers. By significantly reducing the generation of high-density artifacts, MCSNs may facilitate the evaluation of root canal filling quality and the diagnosis of root canal abnormalities.
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Affiliation(s)
- Tingting Zhu
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Guangchao Zhou
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Cheng Chen
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Jingyan Wang
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Peiyu Gu
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Juan Zhang
- Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Huili Wu
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Xiao Zhao
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Diya Leng
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China
| | - Daming Wu
- Department of Endodontics, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Department of Oral and Maxillofacial Imaging, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China; Jiangsu Province Key Laboratory of Oral Disease, Nanjing Medical University, Nanjing, China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, China.
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Shokri A, Eskandarloo A, Zahedi F, Karkehabadi H, Foroozandeh M, Farhadian M. Effect of different intracanal posts and exposure parameters on detection of vertical root fractures by cone-beam computed tomography. AUST ENDOD J 2023; 49 Suppl 1:132-145. [PMID: 36269003 DOI: 10.1111/aej.12700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/24/2022] [Accepted: 10/05/2022] [Indexed: 11/28/2022]
Abstract
This study evaluated the effect of different amperage values and voxel sizes of two CBCT scanners on VRF detection in the presence of different intracanal posts. After post-space preparation, VRFs were induced in half of the samples of 20 maxillary premolars. Five different intracanal posts were passively placed in each root canal. Samples were scanned using CS 9300 and Cranex3D with two different voxel sizes and amperage setting in each unit. The diagnostic sensitivity, specificity and accuracy were compared using the Mann-Whitney and Kruskal-Wallis tests (α = 0.05). Changes in amperage and voxel size did not affect the detection of VRFs (p ⟩ 0.05). The VRF detection accuracy was the highest in fibreglass and the lowest in nickel-chromium group. Changes in amperage and voxel size within assessed values do not seem to influence the detection of VRF whereas different intracanal post-materials have significant effect on VRF detection.
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Affiliation(s)
- Abbas Shokri
- Dental Implants Research Center, Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Amir Eskandarloo
- Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Foozie Zahedi
- Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Hamed Karkehabadi
- Department of Endodontics, Dental School, Hamadan University of Medical Science, Hamadan, Iran
| | - Maryam Foroozandeh
- Oral and Maxillofacial Radiology Department, Hamadan University of Medical Science, Hamadan, Iran
| | - Maryam Farhadian
- Biostatistics, Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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de Lima KL, Silva LR, de Paiva Prado TB, Silva MAG, de Freitas Silva BS, Yamamoto-Silva FP. Influence of the technical parameters of CBCT image acquisition on vertical root fracture diagnosis: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:433-474. [PMID: 36700991 DOI: 10.1007/s00784-022-04797-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To evaluate the influence of image acquisition parameters (voxel, FOV, kVp, mA) on the accuracy of cone-beam computed tomography (CBCT) in detecting vertical root fracture (VRF). MATERIAL AND METHODS Searches were performed in 6 main databases and the gray literature, without restrictions of language or date. Observational clinical studies (OCS) and in vitro-extracted teeth (IV) studies were considered eligible for inclusion when investigating the accuracy (sensitivity, specificity) of CBCT in detecting VRF in human teeth. The risk of bias was assessed using QUADAS-2, and a meta-analysis was performed using Review Manager v5.4 software and Jamovi software v1.6. RESULTS A total of 60 out of 132 articles was included after fulfilling the eligibility criteria. Of these, 54 were IV studies while 6 were OCS. In the IV studies, it was seen that smaller FOV sizes tended to present higher accuracy values. The meta-analysis of the 6 OCS showed that the overall sensitivity and specificity values for 0.08 mm and 0.1 mm voxels were greater (0.84 and 0.79, respectively) than the sensitivity and specificity values for 0.125 mm and 0.2 mm voxels (0.70 and 0.55, respectively). CONCLUSIONS Despite the uncertain risk of bias found for the IV and OCS studies, smaller voxel and FOV sizes seem to provide more accurate VRF detection values when using CBCT. CLINICAL RELEVANCE This information is crucial for supporting the clinician when prescribing CBCT in cases of a clinical suspicion of VRF, and contributes to the personalization of the CBCT prescription, thereby ensuring greater accuracy in the VRF diagnosis. Registration This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42020210118.
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Affiliation(s)
- Kaique Leite de Lima
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Lorena Rosa Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | | | - Maria Alves Garcia Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Brunno Santos de Freitas Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil. .,University of Anápolis, Anápolis, GO, Brazil.
| | - Fernanda Paula Yamamoto-Silva
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil.,University of Anápolis, Anápolis, GO, Brazil
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de Lima Dias-Junior LC, Corrêa M, da Silveira Teixeira C, de Souza DL, Tay FR, Estrela C, da Fonseca Roberti Garcia L, Bortoluzzi EA. Development and validation of a method for creating incomplete vertical root fracture in extracted teeth. Odontology 2023:10.1007/s10266-023-00787-z. [PMID: 36708433 DOI: 10.1007/s10266-023-00787-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/19/2023] [Indexed: 01/29/2023]
Abstract
The present study reported a method for inducing incomplete root fracture in human extracted teeth for the purpose of evaluating the merits of different diagnostic imaging techniques. Thirty-five single-rooted teeth were inspected under magnification and transillumination to exclude previously fractured teeth. Tooth crowns were removed, and the root canals were prepared up to the ProTaper Next X4 (40.06) file. Each root was lined with wax and embedded in a polystyrene resin block. The setup was attached to a universal testing machine for pressing a customized conical wedge (diameter at tip: 0.6 mm; taper: 0.2 mm/mm) into the instrumented canal with a 2 kN load at 5 mm/min. The machine was programmed to stop after a sudden 10% drop in loading force. Each specimen was removed from the resin block and inspected under × 20 magnification and transillumination to identify the fracture characteristics (pattern, surfaces and root-third affected). The gap width of each specimen was measured at different locations along the fracture line. The protocol induced incomplete vertical root fractures in all specimens. Fracture widths were < 100 μm in all specimens (mean gap width: 34.9 μm). The proposed methodology was successful in inducing incomplete vertical root fractures with characteristics that resemble the clinical presentation of these conditions. The method is easy to execute, highly reproducible and helps to minimize bias in laboratory studies that aims to mimic vertical root fractures.
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Affiliation(s)
- Luiz Carlos de Lima Dias-Junior
- Department of Dentistry-Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, Florianópolis, Santa Catarina, Brazil
| | - Marcio Corrêa
- Department of Dentistry-Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, Florianópolis, Santa Catarina, Brazil
| | - Cleonice da Silveira Teixeira
- Department of Dentistry-Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, Florianópolis, Santa Catarina, Brazil
| | - Diego Leonardo de Souza
- Department of Dentistry-Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, Florianópolis, Santa Catarina, Brazil
| | - Franklin R Tay
- Department of Endodontics, The Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Carlos Estrela
- Department of Endodontics, School of Dentistry, Federal University of Goiás, Goiânia, Brazil
| | - Lucas da Fonseca Roberti Garcia
- Department of Dentistry-Endodontics Division, Health Sciences Center, Federal University of Santa Catarina, Campus Reitor João David Ferreira Lima, Florianópolis, Santa Catarina, Brazil.
| | - Eduardo Antunes Bortoluzzi
- Department of Diagnosis & Oral Health, Division of Endodontics, School of Dentistry, University of Louisville, Louisville, KY, USA
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Wang AHT, Panzarella FK, Fontana CE, Junqueira JLC, da Silveira Bueno CE. Effect of cone-beam computed tomography metal artefact reduction on incomplete subtle vertical root fractures. Imaging Sci Dent 2022; 53:11-19. [PMID: 37006793 PMCID: PMC10060756 DOI: 10.5624/isd.20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose This study compared the accuracy of detection of incomplete vertical root fractures (VRFs) in filled and unfilled teeth on cone-beam computed tomography images with and without a metal artefact reduction (MAR) algorithm. Materials and Methods Forty single-rooted maxillary premolars were selected and, after endodontic instrumentation, were categorized as unfilled teeth without fractures, filled teeth without fractures, unfilled teeth with fractures, or filled teeth with fractures. Each VRF was artificially created and confirmed by operative microscopy. The teeth were randomly arranged, and images were acquired with and without the MAR algorithm. The images were evaluated with OnDemand software (Cybermed Inc., Seoul, Korea). After training, 2 blinded observers each assessed the images for the presence and absence of VRFs 2 times separated by a 1-week interval. P-values<0.05 were considered to indicate significance. Results Of the 4 protocols, unfilled teeth analysed with the MAR algorithm had the highest accuracy of incomplete VRF diagnosis (0.65), while unfilled teeth reviewed without MAR were associated with the least accurate diagnosis (0.55). With MAR, an unfilled tooth with an incomplete VRF was 4 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition, while without MAR, an unfilled tooth with an incomplete VRF was 2.28 times more likely to be identified as having an incomplete VRF than an unfilled tooth without this condition. Conclusion The use of the MAR algorithm increased the diagnostic accuracy in the detection of incomplete VRF on images of unfilled teeth.
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Affiliation(s)
- Andréa Huey Tsu Wang
- Division of Endodontics, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Francine Kühl Panzarella
- Division of Oral Radiology, Research Institute, São Leopoldo Mandic Dental School, Campinas, Brazil
| | - Carlos Eduardo Fontana
- Division of Endodontics, Centre for Health Sciences, Pontifical Catholic University of Campinas, Campinas, Brazil
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Bahmani A, Karkehabadi H, Shokri A, Farhadian M. Performance of Bioceramic-based Root Filling Material with Artifact Reduction Properties in the Detection of Vertical Root Fractures Using Cone-beam Computed Tomography. Open Dent J 2021. [DOI: 10.2174/1874210602115010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Introduction:
In Cone-beam Computed Tomography (CBCT) images, metallic artifacts by root filling materials reduce the quality of images. It seems that bioceramic sealers produce fewer artifacts than gutta-percha. In this situation, the possibility of VRF detection could increase, and therefore, flap and exploratory surgery would not be needed. The purpose of this study was to evaluate the performance of a bioceramic-based root filling material in the detection of Vertical Root Fractures (VRF) in CBCT imaging.
Materials and Methods:
This study was conducted at the dental school from March to August 2019, and 100 healthy human mandibular premolar teeth were obtained and randomly divided into two equal groups. The teeth were filled with either AH26 and gutta-percha or bioceramic root filling materials. VRF was induced on half of the decoronated teeth in each group using a Global Testing Machine, and the others were considered control. CBCT imaging was performed by the Cranex 3D machine. Comparisons of the 2 groups were made using the Mann-Whitney test.
Results:
There was a significant difference between the two groups of bioceramic and gutta-percha in the measured indices, including sensitivity (P=0.017), specificity (P=0.018), positive predictive value (P=0.018), negative predictive value (P=0.018), and accuracy (P=0.011). The Area Under Curve (AUC) also showed a significant difference between the two groups (P=0.011). According to Kappa test results, no significant difference was obtained between the findings of the two observers.
Conclusion:
Different root filling materials showed a different extent of artifact in CBCT images. Bioceramic root filling material induces fewer artifacts in CBCT images, and the diagnostic value of VRF in CBCT images in the root canals filled with it is greater than those filled with AH26 and gutta-percha.
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Phaneuf T, Kishen A, Moayedi M, Lam EWN. Effectiveness of Commercial Software-Enhanced Image Artifact Reduction Software. J Endod 2021; 47:820-826. [PMID: 33548328 DOI: 10.1016/j.joen.2020.11.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 11/23/2020] [Accepted: 11/29/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Artifact reduction (AR) software has been incorporated into some cone-beam computed tomographic (CBCT) systems to reduce the severity of beam hardening (BH) artifacts and improve image quality. This study quantifies BH artifact and evaluates the effectiveness of AR in 2 CBCT systems. METHODS Palatal roots of Dent-Alike (Dentsply Sirona, Tulsa, OK) teeth were prepared and root filled with gutta-percha and EndoSequence BC Sealer (Brasseler, Savannah, GA). Six teeth were imaged with and without AR software using the ProMax3D (Planmeca Oy, Helsinki, Finland) and the Pax-i3D (Vatech, Hwaseong-si, South Korea) systems. FSL (FMRIB, Oxford, UK) software was used to quantify the light and dark components of the BH artifact along the tooth root using a specific region of interest approach and an image-wide analysis approach. Statistical analysis was performed using paired t tests and corrected for multiple comparisons with cluster mass correction using a nonparametric statistical analysis to evaluate the differences in the artifact volumes and areas with and without AR. RESULTS A significant reduction in the light artifact was observed with the Planmeca system (P < .05), but no significant differences were observed for either the light or dark artifacts with the Vatech system when AR was applied. There were also significant reductions in the volumes of light and dark artifacts along the entire root length when the AR was applied with the Planmeca system (cluster mass P < .05), but no significant differences were observed with the Vatech system. CONCLUSIONS Proprietary AR software is not equally effective in reducing the light and/or dark components of CBCT BH artifacts.
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Affiliation(s)
- Tyler Phaneuf
- Faculty of Dentistry, The University of Toronto, Toronto, Ontario, Canada
| | - Anil Kishen
- Faculty of Dentistry, The University of Toronto, Toronto, Ontario, Canada
| | - Massieh Moayedi
- Faculty of Dentistry, The University of Toronto, Toronto, Ontario, Canada
| | - Ernest W N Lam
- Faculty of Dentistry, The University of Toronto, Toronto, Ontario, Canada.
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Mazzi-Chaves JF, de Faria Vasconcelos K, Pauwels R, Jacobs R, Sousa-Neto MD. Cone-beam Computed Tomographic-based Assessment of Filled C-shaped Canals: Artifact Expression of Cone-beam Computed Tomography as Opposed to Micro-computed Tomography and Nano-computed Tomography. J Endod 2020; 46:1702-1711. [PMID: 32682791 DOI: 10.1016/j.joen.2020.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/05/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The present study investigated the assessment of root canal fillings in a series of cone-beam computed tomographic (CBCT) images obtained from endodontically treated mandibular molars with C-shaped canals. METHODS Clinically comparable high (HR) and normal (NR) resolution protocols were selected in 3D Accuitomo 170 (J Morita Corporation, Kyoto, Japan), NewTom VGi evo (Cefla QR Verona, Verona, Italy), ProMax 3D Max (Pro; Planmeca, Helsinki, Finland), and Pax-i3D Green Premium (Pax; Vatech, Gyeonggi, South Korea). Micro-computed tomographic and nano-computed tomographic images were considered as the reference standard. The set of images was evaluated according to beam hardening artifact patterns (dark streaks, hypodense areas, and volume distortion). RESULTS Regarding dark streaks, the Fleiss kappa test showed that Pax HR and NR and Pro HR images showed the highest artifact expression. Hypodense areas were detected in 100% and 99.1% of the images obtained using Pax HR and NR, respectively. Kappa tests showed highest distortion for images derived from the Pax and Pro CBCT devices. Root canal filling assessment was considered appropriate in 100% of the 3D Accuitomo 170 HR, NewTom VGi evo NR, micro-computed tomographic, and nano-computed tomographic images. CONCLUSIONS The present study confirms the large variability in CBCT-derived artifact expression. Highlighting the increased artifact expression for particular CBCT systems, it may be concluded that for diagnosis of endodontically filled molars with C-shaped canals, the choice of CBCT unit and protocol is essential.
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Affiliation(s)
- Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Karla de Faria Vasconcelos
- Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Ruben Pauwels
- Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium; Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark; Faculty of Dentistry, Department of Radiology, Chulalongkorn University, Bangkok, Thailand
| | - Reinhilde Jacobs
- Oral and Maxillofacial Surgery, Imaging and Pathology Research Group, Faculty of Medicine, Department of Imaging and Pathology, University of Leuven, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Byakova SF, Novozhilova NE, Makeeva IM, Grachev VI, Kasatkina IV. The detection of vertical root fractures in post-core restored teeth with cone-beam CT: in vivo and ex vivo. Dentomaxillofac Radiol 2019; 48:20180327. [PMID: 31095425 DOI: 10.1259/dmfr.20180327] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare the accuracy of cone-beam CT ex vivo and in vivo for the detection of artificially created large and small vertical root fractures in extracted teeth restored with post-core. METHODS Individual metal cast post-cores were fixed in the root canals of 50 extracted single-rooted human teeth. In 30 teeth fractures were created by tapping posts with a hammer. The teeth were sterilised in autoclave and embedded into bite-plates made of silicon impression material. Cone-beam CT scanning was performed ex vivo and in vivo . For the in vivo scanning, teeth in sterile plastic bags were inserted into the mouths of volunteers. Then the teeth were sectioned with low-speed saw and the widths of the VRFs were measured microscopically. The teeth were distributed into 2 groups in accordance with the measured fractures' widths: large (wider than 180-250 µm) and small (80-150 µm). Five observers assessed the presence of vertical root fractures on axial CBCT slices. Sensitivity, specificity, accuracy and inter examiner agreement were calculated. RESULTS The accuracy of cone-beam CT in vitro for large and small vertical root fractures detection was 0.56 and 0.40 respectively (p = 0.043). The sensitivity values were 0.53 and 0.27 for large and small vertical root fractures, respectively (p = 0.043). The visualisation of fracture lines in vivo was impossible in 90 % of cases, because of low image quality. Inter examiner reliability analysis showed κ values ranging from 0.02 to 0.54. CONCLUSIONS Fracture width affected the in vitro detectability of vertical root fractures by cone-beam CT in teeth with metal cast post-cores. The detectability of root fractures in vivo was decreased because of low image quality, making the assessment of sound tooth tissue impossible.
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Affiliation(s)
- Svetlana F Byakova
- Department of Therapeutic Dentistry, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Nina E Novozhilova
- Department of Therapeutic Dentistry, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Irina M Makeeva
- Department of Therapeutic Dentistry, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Vasiliy I Grachev
- Independent X-ray Diagnostic Laboratory, "3D Lab", Bolshaya Andronievskaya, Moscow, Russia
| | - Inna V Kasatkina
- A.N. Frumkin Institute of Physical Chemistry and Electrochemistry RAS, Moscow, Russia
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12
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Candemil AP, Salmon B, Freitas DQ, Ambrosano GMB, Haiter-Neto F, Oliveira ML. Are metal artefact reduction algorithms effective to correct cone beam CT artefacts arising from the exomass? Dentomaxillofac Radiol 2019; 48:20180290. [PMID: 30540919 DOI: 10.1259/dmfr.20180290] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to evaluate the effectiveness of metal artefact reduction (MAR) in cone beam CT (CBCT) artefacts arising from metallic objects in the exomass. A radiographic phantom composed of 16 polypropylene tubes filled with a homogeneous radiopaque solution was created. CBCT scans were obtained with two units: Picasso Trio (Vatech, South Korea) and ProMax (Planmeca, Finland). The phantom was centred in a 5 × 5 cm field-of-view (FOV) with titanium and CoCr inserts in the exomass. All scans were repeated after enabling MAR. Mean voxel values were obtained from the 16 tubes and standard deviation was calculated as a way of measuring voxel value variability. Mean values and voxel value variability were compared individually in the presence and absence of MAR by means of analysis of variance, followed by Tukey's test (α = 0.05). In the Picasso Trio, MAR significantly decreased mean voxel values (p ≤ 0.05) and increased voxel value variability (p > 0.05) in the presence of titanium. When CoCr was present, no statistical difference (p > 0.05) was observed. In the ProMax, MAR increased significantly mean voxel values (p ≤ 0.05) in the presence of titanium, and presented no significant difference (p > 0.05) for CoCr. Voxel value variability did not differ significantly (p > 0.05) for both materials. In conclusion, MAR was not effective to correct CBCT artefacts arising from metallic objects in the exomass in the two CBCT units used.
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Affiliation(s)
- Amanda Pelegrin Candemil
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Benjamin Salmon
- 2 Orofacial Pathologies, Imaging and Biotherapies Lab and Dental Medicine Department, Bretonneau Hospital, HUPNVS, AP-HP, Paris Descartes University - Sorbonne Paris Cité , Paris , France
| | - Deborah Queiroz Freitas
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | | | - Francisco Haiter-Neto
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
| | - Matheus Lima Oliveira
- 1 Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas , Piracicaba , Brazil
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